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Sociological Perspectives for Health and Social Care

In this assignment the writer will understand and acknowledge the sociological perspectives and the approaches of sociology in the health and social care sector. The essayist will also consider the concepts of sociology within health and social care while exploring the dimensions of health and illness.

Sociology is the study of how the society is organised and how individuals experience life, it is also based on global issues that may affect the living beings. Sociology helps understand the structure and the dynamics of society and the connections between human behaviour and individual life changes. It examines ways in which the forms of social structure, groups, organisations, communities and other various social interactions with how they affect attitudes, actions and opportunities.

Below is the terminology of terms that are related to the health and social care sector and are in relation to the perspectives for sociology.

Social structure is the orderly organisation of the social and statues in the society. It is also the degree of regularity in the form of how people act towards each other in the given group.

The family is a group that helps form, establish or regularise the sexual or procreative function. The primary group is made up of two parents and at least one dependent child whereas they bound by a feeling of a family structure.

Education system is the term used to embrace formal, informal, non-formal learning

Health care services are professional services that are delivered by health care professionals (doctors, nurses, carers, therapists, counsellors). These services may include assessments of health need, planning and coordination of care services, health monitoring, medical administration or supervision and delivery of personal care.

Locality is a place, spot or district with or without its own reference to objects or people in it or to occurrences there.

Social class is the position in the society or group which might be seen as status

Gender is the cultural term which reflects to the social attributes associated with one being male or female.

Ethnicity is the sense of culture or nationality where one belongs.

Age is used to specify the time that a person or objects has existed since birth or beginning.

Socialisation is the term used to describe the process of learning how to behave in society. There are two types of socialisation which are primary and secondary socialisation. Primary socialisation is the socialisation of children which occurs in the family, secondary socialisation is socialisation that takes place beyond the family.

Values are constituent facts of the social structure. There are ideas of experiences whether they are important and they guide a person’s judgement and behaviour.

Culture is based on the values, beliefs, language, rituals, customs and rules that may be connected with a particular social group or society.

Norms are guidelines or rules that may administer how people or groups in society behave and act.

Beliefs are assumptions and convictions that may be held to be true by an individual or groups of people relating to their concepts, events, people and things.

P1

In sociology there are six main principal perspectives which are Functionalism, Marxism, Feminism, Interactionism, Postmodernism, Collectivism and New Right.

Functionalism

In 1951, Talcott Parsons introduced the Functionalist view which studies the social structure as a whole of how it functions and how each social structure is crucial in the interests of society. Functionalism believes that humans and the society have some basic needs, institutions and governments may be responsible to meet the required needs also the functionalist may consider that they are different kinds of sources that may limit the individual’s behaviour within the chosen society, meaning that the society will behave appropriately based on one’s behaviour while having the same values, on the other hand the functionalist view does recognise that there may be errors or inequalities within the society but bearing in mind this can be functional for the society. However there have been criticisms against functionalism as some may believe that it is not a realistic way of living and not considering one’s own choices also functionalism may seem to ignore conflict and diversity within individuals in the society. Parsons sees inequalities as a well function to society as it helps in the running of society or community. The main key idea of functionalism is to ensure smooth running of the society and this is done through the structures of households and family. The weakness of functionalism does not clearly address the conflicts that may arise in the society and does not allow for the individual’s free will this is because the individuals are socialised into their own social roles. Parsons (1951) has created an image for functionalism as a way of positive living and having a function in society.

Marxism

Marxism was introduced and studied by Karl Marx during 1818 and 1883. The Marxist view is based on the conflicts and interests of the society, it also strongly emphasises on the importance of conflict in societies and communities. They also believe that economics are the bases of progressing and social life this can be achieved by struggling through social classes, the change of social class is caused by the class of struggle. The two classes that Marx discussed about were the Bourgeoisie and Proletariat. The Bourgeoisie class is a small powerful group who may have owned factories or own companies whereas the Proletariat is a poorer group of workers. The way a Marxists thinks is based on the financial structures and systems as well as social class meaning that these factors are vital in the Marxist view. However there are several positives and benefits that may link to the main social institutions which highlight the importance of economics within society. Most theorists believe that this philosophy enlightens individuals to some freedom which emphasis on conflict. However the Marxism theory may not be realistic as not every society is based on conflicts. There are some criticisms that the Marxist view believes in for example that they may state saying a person’s behaviour reflects and effects on the socialisation progress also some writers suggest that the Marxist model may focus more on the economy as the institution that as it is the focal point of the society but not emphasising to other institutions as religion, family, culture and race which moulds the behaviour of the individual.

Feminism

Feminism is based on the social experiences from a women’s point of view. In basic terms feminism looks at society fro, a viewpoint of males however making females visible within the society. Feminism has two main bases of roles which are, redressing the balance and study society from a female point of view and to explore women’s lives which often neglected by sociological studies. Pamela Abbott and Claire Wallace (1997) studied the feminism perspective including the concerns and criticisms of malestream sociology. They suggested and argued that the male dominance has produced prejudiced descriptions and analysis meaning people do not focus on the issues that affect women. There are different categories of feminism which study specific aspects of women in the society this includes Liberal feminism, Radical feminism and Marxist feminism.

Liberal Feminism

Liberal feminism looks at the view of legal restrictions of women in the society. Some female members of the liberal feminism believe that changing attitudes and legislations there will be more equality and diversity in society. Liberal feminists consider that if they are improvements this will be resulted in the acts of legislations and policies.

Radical Feminism

Radical feminism is a theory that focuses on the oppressive nature of patriarchy. Btec National Health and Social Care book (2007) defines Patriarchy as a form of society in which men may be seen as being in authority, as power is passed from father to son. Radical feminism concentrates on the socialisation of women as housewives and mothers in the form of oppression while using the characteristic of the nuclear family life.

Marxist Feminism

The Marxist sees feminism as a result of class inequality meaning females are oppressed by both Capitalism and men including the Patriarchal community. Marxist believe that women may produce the next generation of the working trade, also the Marxist feminise believe that females might the required needs for children physically, emotionally and socially meaning that they are ready to work away from home in the future. Marxist feminise says that the mother in the family is the head because without the mother the family will not be able to function and they won’t be someone responsible for the domestic life meaning that this is the primary responsibility of women.

Interactionism

Interactionism is the key concept to understand the society by analysing the behaviours and actions of individuals in a small social group. Interactionism may debate that thoughts and actions may develop based on the types of interactions between the parties involved. Interactionism emphasis and believes that labelling is a method used in many occasions by those in authority also through using the process of labelling stereotypes are developed. Interactionism states that individuals are not just passive however the individual has a particular role within the society on the other hand, fails to understand the reason why some groups in society have the power to label and place constraints on other individuals. Though Interactionism views the individual as having one’s own choice and accepts of the social roles in society this has several criticisms that may not be clearly defined. The theory does not study the root and development for social roles of how they arise. Interactionism is criticised on the insufficient interest on the issues of the power in society. In addition the theory may describe the relationships between health professionals and patients in a health care setting but does not highlight the social factors or the historical factors that may have influenced and caused this specific situation.

New right

New right was a theory that was formed and took place in the 1980s and 1990s which was powerful in shaping the social and economic polices. The New Right has had debates and discussions that the rising costs towards government of the welfare state were preventing economic growth and that the society become more independent on the state. Some may believe that traditional roles within the society may have been undermined by the permissive values during the 1960s and 1970s. The New Right states that a nuclear family is vital to the society and that their is a concern for the rise in numbers of same sex couples and single parents which may be viewed as a negative factor for the society. The New Right also argues that welfare state develops a dependency syndrome among the society and that individuals should take responsibility for themselves and others if possible. The study introduced the market principles into the society, particularly in areas of public life. Theory considers that the free market (state benefits) produces wealth and freedom taking into consideration that traditional values (family, education and nationalism) are being threatened. The New Right has especially been criticised for destroying the community and society due to its emphasis on market principles.

Post-modernism

Post-modernism focuses and stresses the uncertain natures of societies. Modernism is viewed to be a time when study of the world was based on scientific and traditional matters. Post-modernism argues that the range of sociological perspectives may have been superseded due to the nature of society changing in modern advanced industrial societies it also studies the theories as having a part and having interesting views about society. Post-modernism argues that class identity is no longer a vital role in society as it was back in the day but states that they is a large number of factors that may influence people’s lives such as gender, age and ethnicity. Post-modernism suggests that the establishments of the family, religion or the economy are no longer valued as things change in generations meaning that the structuralism perspectives such as Functionalism and Marxism are no longer vital in understanding the society as individuals and groups make their own lifestyle decisions also media is considered as an influential method in society as media creates an image of how people should behave in society. On the other hand, post-modernism has its own criticises as for not taking into account the role of individuals or the relationships between social institutions also some sociologists may disagree that individuals are living in a post-modern society.

Collectivism

Collectivism is set on the political beliefs where is stresses the importance of a collective society. Collectivists believe that collective goals are more significant than individual goals as the society has more value than separate individuals therefore each individual has a responsibility to each other individual. Collectivism mainly studies the importance of society and community while giving priority to group goals over individual goals. Welfare services are generally common and are provided by government funding meaning individuals within the society can expert their government to provide for them. Another way to view collectivism is having an approach to providing health and social care services that may be underpinned by commitment from government to offer care and support for the vulnerable which is funded by tax and National Insurance. The vulnerable audience may include children, older people, and people with physical impairments as well as those with mental health issues. The Beveridge Report (1942) provided the political foundation for a comprehensive range of welfare services. Lord Beveridge in the report of Social Insurance and Allied Services highlighted the five main “Giant Evils” that immediately needed to be challenged.

The provision of keys was placed in the hands of the government, working co-operatively with families and voluntary organisations (multi-agency working) while being financed by the taxes and National Insurance (NI).

Squalor

(Poor housing)

Idleness

(Unemployment)

Ignorance

(Inadequate Education)

Disease

(Ill-health)

Want

(Poverty)

Beveridge’s Five Giant Evils

Figure sourced from: Beryl S and Mary W 2010. Health and Social Care Book 1, Level 3

P2

There are different approaches to health and ill health in sociology that include Functionalism, Marxism, Feminism and Interactionism. There are three main ways that sociology views health meaning negative and positive factors and the holistic way.

In negative terms health is the absence of disease where as the World Health Organisation (WHO) in 1974 defines positive health as a state of complete physical mental, social, spiritual and well being not merely the absence of disease. The holistic approach is based on addressing the individual’s physical, social, emotional and spiritual health while attempting to meet the needs of the individual as a whole the dimensions of the holistic approach were studied and classified by Ewles and Simnett in 1992.

The functionalist approach

The functionalist approach to health is studying the relationship between the sick individual and the society as a whole. Talcott Parsons stated that using the traditional functionalist approach, for the society to function efficiently the members of the society need to be free from illness and must be of well health. The functionalist view in health and social care believes that medicine serves the wellbeing of society as a whole and that the public are protected from people whom may want to abuse the system. The society’s role is controlling limiting the abuse of the sick role by acting as a gate keeper and legitimates absence from work for individuals. This can be achieved by protecting the public from unscrupulous practice and acting as a gate keeper to the sick role if over used this could become a dysfunctional factor.

Parsons suggested that illness is a concept of deviance with ill individuals having a sick role in society. He also suggested that individuals with ill health must be exempt from rights and have responsibilities from the ones that the individuals with well health are entitled to. The sick role rights that ill individuals are exempt from may include being cared for, exempt from social obligations and are exempt from normal family obligations. On the other hand the responsibilities that the ill patient is meant take upon may include co-operating with medical professionals especially doctors and their own staff also managing own health and taking reasonable steps in trying to rejoin and gain back own status in the society. The functionalist approach views is that illness has social consequences.

The Marxist approach

The Marxist approach is aimed at the interests of the capitalists the ruling class. They believe that health is more of the individual’s problem rather than the society issue. This can be achieved by maintaining a health workforce and disguising the true cause of health problems while supporting the profit making of the drug industry. The source of power is established from the servants of the ruling class the power has been delegated through family connections and doctors are becoming proletarianised as they may come under the control of managers. Doctors and other health care professionals are seen as working agents who may work to ensure individuals get back into work and normality. Their job description is to provide the establishment owner with a healthy workplace. Social control is defining illness as an inability to work and making health an individual problem rather than involving the whole society.

The Feminist approach

Feminism concluded that males may seem to dominate the medical professions and that this has a negative impact on the females in the health and social care sector. However, in the past female healers would have been branded as witches on the other hand females have always been the demotion of midwifery to an ancillary occupation. The feminist approach was particularly concerned on how pregnancy and childbirth was viewed as a health pandemic where as they believed it to be a natural process. The feminists view on contraceptives has been that females have been placed in a not so favourable position in using the different prevention methods as there are harmful side effects than the male contraceptive pill. In relation to mental problems feminism argues that most suffers are females due to the exploitation in society and particularly in the family. Interestingly Marxism and other socialist feminists did raise their concerns regarding the impact on the social inequalities on women’s health. Roles in social control may include females dominating in subordinate roles which may be under paid or unpaid carers and drugs or treatments on depression and other related mental health issues.

The Interactionist approach

Interactionism views health and illness as a theoretical approach whereas it is concerned on the processes that may lead the individual to define themselves of ill health, the interaction between the health professional and the patient on agreeing how ill one is also the impact on the individual’s self image and the social contribution if one is labelled as ill. When the interactionsts studies the relationships between health and illness it does not consider the institutions and structures however considers the complexity of relationships of people such as the family and peers and the links with professional services as they believe that the relationships play a major role in medical diagnosis in influencing whether the individual views themselves as of ill health or of well health. There has been several criticisms on the Interactionist approach towards health as some theorists suggest that the approach focuses more on the social relationships than concentrating on the causes of health which may include the explanation and factors that contribute to ill health such as pollution, stress, society and poverty. The main objective of the interactionsts is studying health, impact and the consequences that illness can have on the individual’s life.

M1

In health sociology there are two main models of health which include bio medical and the socio-medical model of health. The models of health assist in explaining what is classified as illness in the modern society however, each model has its own approaches to health issues.

Biomedical model

The study of the biomedical model focuses on the structure and functioning of the body based on the Western scientific approach to medicine, this approach of health relates well to the policies and practice of the National Health Service (NHS). The Western scientific approach to medicine bases on these main features, focusing on the abnormalities in the body, biological factors explain the illness, it examines the cause of ill health through observations and tests, trained health professionals are the ones able to identify and treat the illness, emphasising varied treatments (medications and other interventions), health care environments are appropriate places to undergo treatments and the model specifically states that illness is regarded as a temporary condition which can be reversed by the intervention of medical expertise. The bio medical model relates to the functionalist approach of health as it specifies that health is the absences of disease and it’s regarded as dysfunctional for the society as individuals can not make positive contribution to the running of society. The model does not consider the social and environmental factors of ill health but relays on the scientifically methods to address and diagnose the illness if the illness cannot be diagnosed the individual would be labelled as malingering meaning one will be pretending to be ill for own personal reasons such as staying off work, school, to collect benefits and other personal matters.

Socio-medical model

The socio-medical model is an approach to health and illness that emphasises on the environmental and social factors that may manipulate the health and well being of the individual in society including the impact of poor housing, diet, pollution and economic matters. From analysing the functionalist theory it shows that the socio medical model would explain and discuss the high rates of ill health and the short life expectancy among those who are poor relating to the inequalities in society and life circumstances of those whom may be disadvantaged. In 1974, McKeown wrote up a case study showing the health improvements that were made in regards to environmental factors the case study showed that improving the sewerage systems, providing clean water supplies and better nutrition (diet) would dramatically improve life expectancy, putting this in practice the case study showed that changes to society would positively impact to those affected. Those who may regard themselves as poor state that they are likely to have an inadequate diet and have poor housing due to finance problems those affected are likely to reside in inner-city areas where environmental pollution and high rates of poor employment rates are low also in the past it showed that people with malnutrition other health related problems would be labelled as being in poverty and having poor living standard. The socio medical model states that there are preventable deaths in the modern Western society that may be linked to personal choices and behavioural factors these may include smoking, misuse of drug in taking, drinking excessively and diet however, in developing countries the lack of clean water is mainly responsible for the high rate deaths of childhood this was proven by the United Nations as they also included that 4000 deaths and diseases were caused by drinking dirty water. On the other hand, ruling groups or individuals in the society believe that the government need to make changes for the poor and others affected so as to protect them from ill health and other diseases.

Rogers and Pilgrim emphasise the correlation between the two models as it can be demonstrated unequivocally that social stress is in correlation with the social class. Relating to the Marxist critique of the bio-medical model as it is a direct consequence of capitalism that a class that is more at risk to contract illness through sue to the cause of economic status. Some sociology theorists may believe that the medical profession is under the educated upper classes who are interested in keeping the lower class content while using the workforce for growth and economy.

Strengths

Weaknesses

Diagnoses the cause of ill health through the methods of observations, examinations and tests.

Does not address the social and psychological factors that contribute to good health.

Focuses on the physical processes of bio chemistry, pathology and the physiology of the illness.

Is criticised for being technology centred and expensive.

Illness is a temporary state that can be changed by the intervention of medical skill.

Assumptions of generic disease however symptoms treated like disease

For the functionalist if individuals take upon a sick role one must be exempt from social responsibilities.

Refers to the abnormal changes in the body’s structure or the functioning as a disease

In the 21st Century the model remains powerful in Western medicine.

Only medical professionals have the expertise to identify and diagnose the illness.Bio medical model

Socio medical model

Strengths

Weaknesses

Understands and considers the patients experiences. Government recommends topics of improving mental health.

Failure to fully discuss the psychosocial factors which have proven to be powerful factors of disease in the modern society.

Recognises the effectiveness of the promotion of health via polices and legislations.

It can be time consuming in studying the factors affecting illness and lack of prevention methods.

Introduced the treatment for mental health problems.

Omits the dimension of power so as to avoid inequality in health.

It’s been a success in diagnosing and treating several diseases in centuries.

Does not assess the causes of ill health genetically or research in depth.

Believes that health can be improving the social conditions as it can affect health of some particular groups.

Is not satisfactory in the understanding of the development of policies of the disability and the disadvantaged.

P3

Epidemiology is the study of how illnesses and diseases are spread through the society this is vital as it provides the scientific base for examining health. Statistical data is used to explain the patterns and trends in health and illness among different social categories such as gender, social class, ethnicity, age and geographical location the information collected helps researchers in finding the root cause of illness and diseases. However measuring health can be difficult as there can be various definitions of health and the concepts of the clinical iceberg which can paint a false picture of health in the chosen community.

Gender

It is commonly known and proven that the life expectancy of women is higher than of men, studies continuously show that the levels of illness for women than for men. The social factors that may contribute to the differences can be indentified as risk factors or economic inequalities. Risk factors can relate to the high death rates of men which may be linked with the high levels of binge drinking or smoking including men participating in risky and dangerous activities also males between the ages of 17 and 24 also have a high death rate this might be due to deaths associated with road accidents or similar activities. Economic inequalities relates to females being treated unequal to males. The most in equal treatment of females in the working society is that a higher proportion of women than men are in low paid part and full time work also women are most likely to be the main carer if in a lone-parent family this results that the women may not be entitled an employer’s pension because of the family responsibilities.

Employee jobs by sex and industry, June 2002.

Source:

Short-term turnover and employment survey, 2002, Office for National Statistics.

Ethnicity

Studying the relationship between ethnicity and illness is difficult this is because it is systematically difficult in defining one’s own racial type as there is an increase of those who may be mixed race. A majority of ethnic groups that may reside in inner city areas which is located with poor housing, pollution and high rates of unemployment meaning that it is a difficult to understand whether the poor health and the arise in illness is due to poverty or ethnicity. There are also varies reasons to poor health and they are factors that may contribute to this due to ethnicity problems for example language can be a barrier limiting the full use of the health services also in the Asian community women are hesitant in being examined by a male doctor this can be a barrier improving the patient’s health. In the health and social care setting it is the health carers make take own responsibility in understanding and acknowledging the religious, cultural beliefs and practices of different ethnic groups if not so the patient’s care needs may not be fully met meaning that the individual is at risk of contracting ill health.

Population in hospitals and other care establishments: by ethnic groups, April 2001

Source:

Census, April 2001, Office for National Statistics, General Register for Scotland.

Social class

Social class is partly essential when reading the pattern of health and illness as it can identify those with longer life expectancy as it can vary according to social groups. The Black Report by Townsend at al, (1980) is the most powerful study in the modern health the study clearly provides explanations based on the relationships between the social and environmental factors in regards to health and illness while focusing on life expectancy. The study has also showed significant evidence of those individuals in the upper social class as having a longer life expectancy and having better health than those in of the lower social group. The Black Report indentified four main types of explanations that may explain the differences in the levels of illness and life expectancy which may be experienced by different social groups. Many theorists were convinced that the differences in health and well being were caused by the individual’s financial state and one’s living conditions. The Black Report explained the four possible sociological differences which were the statistical artefact, natural or the social selection, cultural or behavioural including material and structural explanations.

Age

The age patterns of health and illness can tend to be true among the older generation as they illustrate that individuals over the age of 75 have a high rate of illness. In 2003 during a three month period it showed that 24per cent of patients aged 75 would have attended casualty and the out-patient department in comparison with 14per cent of all other individuals in a different age group. Stating from the Alzheimer’s Society during 2007 they estimated that one in 20 people over the age of 65 and one in five people over the age of 80 suffered from dementia.

Geographical location

Health and illness can relay on the regional variations. The morbidity and mortality rates certainly differ in different parts of the state and also the surrounding cities and towns within that particular country. Morbidity rate is the proportion of individuals who suffer fro a particular disease and mortality rate is the proportion of people who may die from a disease. The recordings show and prove that the poorer the region is the poorer the cities are meaning that they will be high levels of ill health and varies diseases this might be due to the lack of health education or the failure of government polices and procedures.

Deaths due to diseases accounted by each region, 2001.

Sourced:

Geocases

M2

To understand the patterns and trends in health and illness among different social categories specialists and statistical methods are used to measure health. Statistical trends in levels health and illness are grouped in to three main classes which are government statistics, charitable organisation with pressure groups and academic researchers working with other authors. Government statistics is the use of The Office of National Statistics which provides recent information on the sociology issues that relate to the health and social care topics, statistics can come in variety of formats. Information can vary from birth and death rates including hospital admissions. Where as, charitable organisations and pressure groups collect and distribute statistical and other related issues which discuss the trends in health and illness. The academic researchers and other authors are mostly based in universities where by they debate and contribute facts on the health and social care issues.

There are several difficulties in defining health and the measuring of health. Defining the term health has always been an issue for social scientists meaning scientists had a number of definitions of healthy and unhealthy or suggesting “normal” and pathological approach also the term varies between professional and academic studies. Biological explanations differ from social constructionist accounts with minimum agreement on the causes and conditions of ill health. The writer would suggest that to get relevant on information regarding health and illness it is best to research multi perspectival approaches.

Difficulties in defining health

Issues relating to the reliability of statistical data

D1

Strengths and weakness of health and well being

Judgement make a conclusion

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